The Cancer Incidence Rate A focus on prevention, such as more accurate and early diagnosis, has reduced the rate of cancer/100,000 residents by 0.9% annually during the past decade. More Americans are surviving cancer because of advances in detection and treatment. An increasing population that is living longer, however, is adding to the number of cancer patients. Increased insurance coverage under the Affordable Care Act (ACA) has provided more Americans with access to cancer screening. The latest Centers for Disease Control (CDC) data (2015) reported 1,633,390 new cancer diagnoses and 595,919 cancer deaths in the US. The American Cancer Society forecasted 1,735,350 diagnoses for 2018, and 609,640 deaths.

Cancer Specialists Wanted A survey from the Association of Community Cancer Centers found almost half (47%) of cancer treatment institutions reported vacancies for medical oncologists. By 2020, experts forecast a shortage of 3,800 oncologists. Community cancer clinics have been struggling. During 2018, 423 clinics closed, 359 indicated that they were struggling financially and hospitals acquired another 658. The most closures were in Florida (47), Texas (43) and Michigan (36). The US Congress’ 2% budget sequester has hurt community cancer clinics, cutting Medicare Part B reimbursement, including for drugs. The clinics are now responsible for the cost of the non-reimbursed and expensive drugs, driving many from business.

The Oncology Practice According to 2016 American Society of Clinical Oncology (ASCO) data, 42% of cancer practices were physician- owned, 36% hospital- or health system-owned and 22% academic institution-owned. Oncologists said their practice’s biggest pressures were increasing practice/facility expenses (54%), drug pricing (41%) and electronic health record (EHR) implementation and use (39%). Oncology practices, particularly physician- and academic- owned, also cited payer pressures, including prior authorization requirements, which delay care, coverage issues and costs. A third hired oncologists while 10% eliminated some.

Oncologist Profile Only 26% of oncologists were female, according to the 2018 MedScape report, but ASCO reported 32%. Two- thirds of oncologists think they are fairly compensated and 96% would choose the same specialty at the start of their careers. According to the Medscape Physician Compensation Report 2018, oncologists earned, on average, $363,000 per year, an increase of 10% from 2017, and were ranked 10th in total compensation among specialists. One-quarter of all oncologists are in California, New York and Texas. Massachusetts, New York and the District of Columbia have more than 20 oncologists/100,000 residents 55+. Nevada, Idaho and Hawaii have the lowest density, less than 10/100,000 residents.

The Cancer Patient There are, on average, five oncologists/100,000 urban residents, but only one/100,000 rural residents. For this reason, as well as poverty and lack of health insurance, residents in Appalachian states are more likely to die of cancer. Although the overall probability of contracting cancer during one’s life is 34% for both sexes, men age 60–69 have a 14% probability, compared to 10% for women the same age. Men 70 and older have a 34% probability compared to 25% for women. African Americans have the highest incidence of cancer, at 560.9/100,000 residents; followed by Caucasian Americans, 510.7; American Indian/Alaska Natives, 425.3; Latino Americans, 386.3; and Asian/Pacific Islanders Americans, 302.8.

Advertising Strategies Based on the data from The Media Audit on page 4 of the Profiler, potential cancer patients in higher income brackets and with the largest indices in the data could be reached effectively with upscale sports programming, such as golf, tennis, horse racing, etc. Oncology practices may want to emphasize how they help patients reduce and manage the high costs of care by referring them to patient-advocacy and similar organizations. Oncology practices can differentiate themselves by highlight advanced therapies, telemedicine services and the inclusion of a genetic counselor on staff.

New Media Strategies Many, if not most, prospective patients will have many questions. Use social media to ask people to submit their questions about cancer and care, and then provide a short answer as future posts on all social media pages. Start a curated news section on your Website with weekly uploads of the latest news stories about cancer, treatments and new drugs and therapies. Include links to the stories in an e-newsletter. Because the level of care and the oncologist who provides is so important to patients and their families, oncologists should record and post a quarterly video on their Websites and social media pages with both professional and personal messages to build trust.